2. Research can be defined as the systematic
collection, description, analysis and
interpretation of data to answer a certain
question or solve a problem.
Health research can also be defined as the
process for systematic collection, description,
analysis and interpretation of data that can be
used to improve the health of individuals or
groups.
Dr Rajeev Kashyap
3. Health research has been broadly defined
as the generation of new knowledge using
the scientific method to identify and deal with
health problems.
(Commission on Health Research for Development, 1991)
Health research is thus not limited to the
biomedical field. Other fields of science can
contribute much to the improvement of our
understanding about health issues.
Dr Rajeev Kashyap
4. Key attributes of good research are
Planning,
accuracy in data collection
and
ProPer unbiased interPretation.
Policy-makers and funders of research,
on the other hand, would like to see
research targeted to respond to priority
health needs.
Dr Rajeev Kashyap
5. Concerns about ethics in health research,
general ethical principles.
Responsibility for maintaining ethical
standards.
And
The duties of ethics committees which
review and approve research.
Dr Rajeev Kashyap
6. Beneficence
Non-maleficence
Respect and justice
Ethics are principles of right conduct. since
they represent basic human values. There
can , however, be differences on how they
are interpreted and implemented in specific
cases.
Dr Rajeev Kashyap
7. No one shall be subjected to torture
or to cruel, inhuman or degrading
treatment or punishment. In
particular, no one shall be subjected
without his free consent to medical
or scientific experimentation
International Covenant on Civil and Political Rights, Article 7, 1966
Dr Rajeev Kashyap
8. • Biomedical sciences: These include all
biological, medical and clinical research, and
biomedical product development and evaluation.
• Population sciences: These include
epidemiology, demography and the
sociobehavioural sciences.
• Health policy sciences: These include health
policy research, health systems research and
health services research. Economic analysis
studies are now an important subcategory of
health policy research.
Under each category, there are a growing number of
specialties and sub-specialties.
Dr Rajeev Kashyap
10. In many types of biomedical research, discovery is
the prize in the research game. But hunting for
discovery is not a straightforward undertaking.
Many of the drugs we use today have been
discovered in research programmes designed for
other purposes. Minoxidil (the drug for male
baldness) was originally developed and tested for
the treatment of hypertension. Sildenafil (Viagra),
used for the treatment of erectile dysfunction, was
discovered in a cardiovascular research
programme.
Dr Rajeev Kashyap
11. In 1889 in Strasbourg, while studying the function of
the pancreas in digestion, Joseph von Mering and
Oscar Minkowski removed the pancreas from a dog.
One day later, a laboratory assistant called their
attention to a swarm of flies around the urine from
this dog. Curious about why the flies were attracted
to the urine, they analysed it and found it was loaded
with sugar, a common sign of diabetes. But it was
only in 1921 that Canadian researchers Fredrick
Banting (a young medical doctor), Charles Best
(a medical student), and John Macleod (a professor)
could extract the secretion from the pancreas of
dogs, inject it into dogs rendered diabetic, and prove
its effectiveness (Roberts, 1989).
Dr Rajeev Kashyap
12. Health policy-makers at the national and
international level would like to see
research driven by the health needs, with
a return on the investment that can
decrease the disease burden on their
people.
The relative magnitude of a health
problem is determined by its prevalence
and its seriousness. A health problem may
be prevalent but not serious, and may be
serious but not widely prevalent. The
tradition in the past has been to consider
mortality as the measure for the
seriousness of a health problem.
Dr Rajeev Kashyap
13. Mortality does not always go with morbidity. Some
disease conditions leave the patient seriously
morbid but do not kill. Conversely, some diseases
either kill or leave no long-term impairment in
health.
The burden of disease as a result of any health
problem is commonly expressed as the disability-
adjusted life years (DALYs) lost. This measure
expresses both time lost through premature death
and time lived with a disability.
Dr Rajeev Kashyap
14. A health problem is of high magnitude does not
necessarily mean that it should be a priority for
research. The know-how to deal with the
problem may be already available, but it is not
applied and made available. The need may
be for action and not for research.
Research should not be an excuse for delaying
action.
Dr Rajeev Kashyap
15. Industry has become a major actor in health research.
The research and development share of sales revenues
varies among pharmaceutical companies, but is
estimated on average to be 13%. In the 1990s, seven
countries—United States of America, Japan,United
Kingdom, Germany, Switzerland, France and Italy (in
decreasing order)—conducted 97% of all worldwide
pharmaceutical research and development
(Murray et,al. 1994).
Pharmaceutical industry investments in research and
development surpassed public investments in four of the
countries (France, Japan, Switzerland and United
Kingdom).
Dr Rajeev Kashyap
16. The direction for research and development in industry is pushed
by the new developments in technology, which provide new leads
for developing new drugs. The market pull impacts, however, on
the technology push, and thus on the opportunities for research.
For example, in the industrialized countries people over 65 years
old spend the most on drugs. This aging population is driving new
and expanding markets. New drugs are targeting age-related
disorders and enhancing quality of life for the elderly
(Burrill,1998).
The recent top-selling drugs were mostly in this category, for
example Eli Lilly’s Evista for osteoporosis, Merck’s Propecia for
male pattern baldness, Pfizer’s erectile dysfunction pill Viagra
(with estimated sales of US$ 2 billion by 2000), and Monasto’s
Celebra for arthritic pain.
Dr Rajeev Kashyap
17. Selection of a topic for research may be driven by
opportunity. The opportunity comes with the
availability of funding, the chance to participate in
collaborative international research, and working
with the pharmaceutical industry.
Availability of funding :Funding for health research
basically comes from either public sources,
including governments and intergovernmental
organizations, or private sources including for-
profit pharmaceutical industry and not-for-profit
agencies,
Dr Rajeev Kashyap
18. • Role of health research in improving health and
stimulating national economic growth is now well
established.
• Health research supports health systems in the delivery
of better, fairer and more equitable health care to
people.
• It does so by identifying challenges and providing best
solutions, monitoring how health systems perform and
producing new knowledge for better technologies and
improved approaches to public health.
Basic research provides the pool of knowledge from
which leads for applied research
Dr Rajeev Kashyap
19. All nAtionAl And
provinciAl heAlth policies
should be bAsed on vAlid
scientific evidence.such
evidence requires
reseArch;
And
the ApplicAtion of the
knowledge, informAtion
And technology
Dr Rajeev Kashyap
20. good reseArch
ideAs come from the
knowledge, work
And Attitudes of
reseArchers.
Dr Rajeev Kashyap
22. • Health research must serve as a driver for health
policy and practice
• The literature on research methodologies is vast.
Researchers and scientists worldwide nowadays
have access to enormous, and growing,
information resources which provide in-depth
knowledge, training and education to enhance and
improve research.
• Inadequacy in capacities for research and
development remains a major impediment for the
developing world
Dr Rajeev Kashyap
23. It does so by
Identifying challenges and providing best solutions,
Monitoring how health systems perform and producing
new knowledge for better technologies and improved
approaches to public health,
Health research supports health systems in the
delivery of better, fairer and more equitable health
care to people.
Dr Rajeev Kashyap
24. However, in the field of health research, and
science in general, the “pure” (basic) versus
“applied” debate has raged for decades and
shows no signs of abating.
There has been a move to emphasize and
promote research that has the potential to
improve health or quality of life, i.e. applied
research.
Dr Rajeev Kashyap
25. Clinicians are trained to think
mechanistically, and clinicians are therefore
most familiar with quantitative research.
However, medicine is not only a mechanistic
and quantitative science.
Patients are not broken down machines or
malfunctioning biological systems.
Doctors do not treat diseases;
doctors treat patients
Dr Rajeev Kashyap
26. Health is more in the hands of people than in the
hands of health professionals.
Qualitative research is needed to provide
insights into people’s lifestyle behaviour,
their knowledge, their feelings and
attitudes, their opinions and values and
their experience.
Having a good health system structure in place is
not enough to ensure good quality health care.
Dr Rajeev Kashyap
27. How the system functions and the attitudes of
health care providers can make all the
difference.
Quantitative research gives adequate results
about the anatomy of the system.
A quantitative study may be complemented
with a qualitative study to provide further
insights into the findings
Dr Rajeev Kashyap
28. Qualitative research can help in closing the
gap between the science of discovery and
the implementation of results.
Qualitative research is often needed to find
out why research results are often not
translated into practice.
Incorporating qualitative research
methodologies into research thinking
ensures that the right methodology is
brought to bear on the right question.
Dr Rajeev Kashyap
29. Action research is a style of research, rather than a
specific methodology. In action research, the
researchers work with the people and for the people,
rather than undertake research on them.
The focus of action research is on generating solutions
to problems identified by the people who are going to
use the results of research.
Action research is not synonymous with qualitative
research. But it typically draws on qualitative methods
such as interviews and observations.
Dr Rajeev Kashyap
30. A common misconception is that health economics is
about cutting costs. In economic evaluation, costs are
regarded as opportunity costs.
Health economics is a logic framework which allows
us to reach conclusions about the best way that
resources can be allocated.
As resources are scarce, each decision to use
resources in one way implies a sacrifice of another
opportunity to use the resources in an alternative way
Dr Rajeev Kashyap
31. A scientific approach is essential for health professionals.
As the practice of medicine is advancing rapidly, the need
for critical evaluation of new developments becomes more
urgent.
Research helps to develop a scientific critical attitude. A
clinician will find that the faculties developed by doing
research are those most needed in clinical diagnosis.
Health policy-makers, particularly in developing countries,
may not appreciate the contribution which research can
make. There is still a divide between the universe of
research and the universe of policy-making.
Dr Rajeev Kashyap
32. Pharmaceutical companies in the past to do
most of their research and development in-
house. Nowadays, a growing number of
pharmaceutical companies commission their
research to reputable centres in universities.
Many companies today outsource more than
30% of their research and development budget
and all or part of their clinical research and
development (Burrill, 1998).
Dr Rajeev Kashyap
33. A Practical Guide for Health Researchers
Mahmoud F. Fathalla
Dr Rajeev Kashyap
